Assessment of pregnancy cigarette smoking and factors that predict denial

To determine rates of pregnancy smoking concealment compared to behavioral observation and to identify factors predicting untruthful denial.

Review of 843 delivery charts.

Based on observation during delivery hospitalization, 8% of smokers denied hospital admission, 16% denied throughout prenatal care. Compared with those admitting smoking, false deniers had higher levels of education, incomes and adequate prenatal care utilization; and were less likely to have drug use, STDs, or hepatitis C. Observation was a valid tool for assessing smoking status.

Typical concealers were those considered lower risk, increasing the chance they would go undetected as smokers.